Characteristics and treatment of pericarditis after vein of Marshall
Ethanol infusion for persistent atrial fibrillation
Abstract
Background: The vein of Marshall ethanol infusion (VOM-EI) provides an
opportunity to achieve bidirectional conduction block of mitral
isthmus. However, this technique may induce traumatic
pericarditis. There is a lack of research on which populations are prone
to pericarditis after VOM-EI and how to treat it more effectively.
Methods: This retrospective study included 77 consecutive patients who
voluntarily underwent persistent atrial fibrillation radiofrequency
ablation combined with VOM-EI. With the occurrence of postoperative
pericarditis as the end point, the characteristics and risk factors of
postoperative pericarditis were analyzed. The curative effect was
evaluated by the symptom relief rate of pericarditis 48 hours after
treatment. Results: 15 had postoperative pericarditis among the 77
patients, accounting for 19.5%. The hospital stay of the patients with
pericarditis was longer than that without pericarditis (10.0 vs 8.0
days, P = 0.045). Of the 15 patients with postoperative
pericarditis, 8 received colchicine. Among the patients treated with
colchicine, the average treatment intensity was 1.04 mg/d, 7 patients
were relieved within 48 hours, and the symptomatic remission rate was
87.5%. Among the remaining 7 patients who did not receive colchicine,
only 2 patients had symptomatic remission. Compared with the group
without colchicine, the duration of symptoms was significantly shorter
(27.88 vs 51.93 hours, P = 0.024). In the multivariate logistic
regression analysis, colchicine was the only effective method to relieve
the 48 hours symptoms of postoperative pericarditis ( OR =17.500,
CI 1.223-250.4, P = 0.035). Conclusion: Postoperative
pericarditis is one of the complications of VOM-EI, and colchicine may
have a good short-term effect on it.